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N727 Remark Code: No-Fault Insurer Has ORM

N727 means a no-fault insurer, typically auto personal injury protection coverage, has reported ongoing responsibility for medical services (ORM) for this diagnosis. The payer expects the no-fault carrier to pay first for related care.

Quick facts

Code
N727 (RARC N727)
Status
Active In use since March 1, 2014.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The payer denies because the no-fault carrier is primary for this condition. Do not bill the patient for it.
  • OA (Other Adjustment): Some payers use OA to show another payer is responsible. It is a routing issue, not patient balance.
Official description
A no-fault insurer has reported having ongoing responsibility for medical services (ORM) for this diagnosis.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N727 means

No-fault coverage, usually personal injury protection in an auto policy, pays accident-related medical bills without regard to fault. When a no-fault carrier accepts ongoing responsibility for medicals, it can report that to payers such as Medicare. N727 tells you the diagnosis on your claim lines up with that report.

The payer denies or redirects the service, commonly with CARC 21 or CARC 22, because the no-fault carrier is primary. Rules on no-fault coverage, limits, and billing forms vary by state.

Common causes

  • Follow-up care for an auto accident was billed to the health plan instead of the auto carrier.
  • The patient’s accident was not recorded at check-in.
  • The no-fault benefits were used up, but the carrier’s ORM report was never closed.
  • An unrelated visit carried an accident-related diagnosis.

How to fix it

  1. Get the no-fault carrier, claim number, and accident date from the patient.
  2. Bill the no-fault carrier for accident-related services, following that state’s no-fault billing rules.
  3. If benefits are exhausted or the carrier denies, send the carrier’s letter or explanation of benefits to the payer that issued N727 and ask it to reprocess.
  4. If the visit is unrelated to the accident, review the diagnosis coding and request reprocessing.

How to prevent it

Ask about recent motor vehicle accidents during registration, and store the no-fault claim details on the patient account. That lets billers send related claims to the right carrier on the first attempt.

Codes that may appear with N727

  • CO-21 (This injury/illness is the liability of the no-fault carrier.): The injury or illness is the no-fault carrier's liability.
  • OA-22 (This care may be covered by another payer per coordination of benefits.): Care may be covered by another payer under coordination of benefits.
  • N725 (A liability insurer has reported having ongoing responsibility for medical services (ORM) for this diagnosis.): A liability insurer, not a no-fault carrier, has ORM.
  • N728 (A workers' compensation insurer has reported having ongoing responsibility for medical services (ORM) for this diagnosis.): A workers' compensation carrier has ORM.
  • N724 (Patient must use No-Fault set-aside (NFSA) funds to pay for the medical service or item.): The no-fault claim settled and a set-aside is now the payment source.
  • N744 (Adjusted because the services may be related to an auto/other accident.): The payer suspects an auto or other accident but has no confirmed ORM on file.

N727 FAQ

Do I bill the auto insurer after N727?

Yes, for services related to the accident. You will need the no-fault carrier's name, claim number, and adjuster details, which the patient can usually provide.

What if no-fault benefits are exhausted?

No-fault policies often have coverage limits. Obtain the carrier's exhaustion letter or final explanation of benefits and send it to the payer that issued N727 so it can reprocess.

Does N727 apply to every claim for this patient?

It should apply only to claims whose diagnoses relate to the accident. Unrelated care should process normally; if it does not, contact the payer.